Request an Estimate

Use the form below to make a request for an estimate of medical services. Please complete the form in its entirety by submitting the requested information. If you are not the patient requesting the information (except on the behalf of a minor) you will need a Power of Attorney or a Release of Information form when submitting the request. Parrish Medical Center offers two ways to file a "Request for Estimate."


Option 1:

Fill in the following form

Denotes Required Field

Patient Information












Physician Information





Option 2:

Fill out the document below and mail to Parrish Medical Center

Request an Estimate PDF

Request for an estimate of charges are for hospital services only. The estimate does not include the reading or interpretation or the examination, which may be required. This is a good faith estimate based on the current Charge Master and an average of previous procedures performed at Parrish Medical Center.

Parrish Healthbridge: Healthcare Simplified

For education, breaking news or a message from your physician, HealthBridge will get it to you quickly.

  • Healthy Living

    Parrish Wound Healing Centers Receiv...

    Parrish Wound Healing Centers Receive National Awards for Excellence in Wound Care TITUSVILLE, PORT ST. JOHN, FLA. (February 23, 2017)&mdas...

  • Healthy Living

    Charity Tennis Tournament Benefitin...

    Charity Tennis Tournament Benefiting Cancer Programs to Feature Bryans, Hobgoods in ‘Battle of the Brothers’ TITUSVILLE, FLA....

  • Healthy Living

    Parrish Medical Center earns Top 100...

    Parrish Medical Center earns Top 100 SafeCare Hospitals® distinction Only 2 percent of all US hospitals earn this SafeCare distinction...

  • Healthy Living

    Parrish Medical Group Welcomes Famil...

    Parrish Medical Group Welcomes Family Practice Physician Benjamin Nettleton, DO PORT ST. JOHN, MELBOURNE & TITUSVILLE, FLA. (Jan. 20, 2...

  • Healthy Living

    Parrish Medical Group Welcomes Ortho...

    PORT ST. JOHN, MELBOURNE & TITUSVILLE, FLA. (January 16, 2017)—Parrish Medical Group, with offices in Titusville, Port St. John an...

  • Healthy Living

    New Board Officers Named

    New Board Officers Named TITUSVILLE, FLA, January 10, 2017--Parrish Medical Center's board of directors, in accordance with its bylaws, h...

  • Healthy Living

    DaVita, Parrish Medical Center Annou...

    DaVita News Release: DaVita, Parrish Medical Center Announce Joint Venture to Deliver Full Suite of Kidney Care Services in Titusville TITU...

  • Healthy Living

    2016 Gift of Light Tree Lighting and...

    2016 Gift of Light Tree Lighting and Fireworks Extravaganza at Parrish Medical Center, Dec. 1, 6-8 p.m. Benefiting Jess Parrish Medical F...

  • Healthy Living

    Josh Field Joins Parrish Medical Cen...

    Josh Field Joins Parrish Medical Center Executive Team Marketing Executive to Head Corporate Branding and Marketing Strategy TITUSVILLE...

Our Services

PMC helps our community stay healthy by living our vision of Healing Families—Healing Communities®

See Services

Classes & Events

Get healthy—and stay that way!—with dozens of classes, events and support groups to choose from every month.

See Calendar

Accomplishments

Parrish Medical Center is among the nation's best in clinical care, safety and patient experiences.

See Awards

Patient Stories

Need a little get-healthy inspiration? Read about how people just like you have transformed their lives.

See Stories

Web Nursery

Parents of babies born at PMC can choose to have a picture of their baby posted.

Find Pictures

Urgent Care Scheduling

Reserve a space at urgent care locations, as well as make an appointment at a physician's office.

Check In